title: [Changes in the epidemiology of fungaemia and fluconazole susceptibility of blood isolates during the last 10 years in Spain: results from the FUNGEMYCA study].
abstract: BACKGROUND
  Recent epidemiological surveillance studies have reported an increase in fungaemia caused by non-Candida albicans species, as well as a decrease in fluconazole susceptibility.
  
  
  OBJECTIVE
  To evaluate changes in the epidemiology of fungaemia in Spain comparing data from a new surveillance epidemiological study conducted in 2009 with a previous study carried out from 1997 to 1999 (Pemán J, et al. Eur J Clin Microbiol Infect Dis. 2005).
  
  
  METHODS
  From January 2009 to February 2010, 44 Spanish hospitals participated in a prospective multicentre fungaemia surveillance study to ascertain whether there have been changes in the epidemiology and fluconazole susceptibility. Susceptibility was determined by the colorimetric method Sensititre Yeast One. Demographic and clinical data and the first isolate of each episode were gathered.
  
  
  RESULTS
  A total of 1,377 isolates from 1,357 fungaemia episodes were collected, 46.7% from patients older than 64years and 8.6% from children less than 1 year old. C. albicans (44.7%), Candida parapsilosis (29.1%), Candida glabrata (11.5%), Candida tropicalis (8.2%), and Candida krusei (1.9%) were the most frequent species isolated. Distribution varied with the geographical area. C. albicans incidence has increased significantly in the last 10years in Cataluña (39.1 vs. 54.7%, P=0.03) and decreased in the Valencian Community (49.1 vs. 34.6%, P=0.002) and Extremadura (58.3 vs. 20%, P=0.01). Susceptibility to fluconazole was similar for all geographical areas, although resistance in C. albicans was ten times greater for patients aged more than 64years. The overall rate of fluconazole resistance (MIC > 32 mg/L) has decreased with respect to that obtained 10years ago (3.7 vs. 2.5%) mainly in C. albicans (3 vs. 1.6%).
  
  
  CONCLUSIONS
  In the last ten years, species distribution and fluconazole susceptibility have not significantly changed, although a lower rate of fluconazole resistance has been observed. Species distribution varies with hospital, hospitalization Unit and geographical area.
authors.affiliation: Servicio de Microbiología, Hospital Universitario La Fe, Valencia, España. peman_jav@gva.es
authors.forename: Javier
authors.initials: J
authors.lastname: Pemán
authors.forename: Emilia
authors.initials: E
authors.lastname: Cantón
authors.forename: Juan José Camarena
authors.initials: JJ
authors.lastname: Miñana
authors.forename: Julia Alcoba
authors.initials: JA
authors.lastname: Florez
authors.forename: Julia
authors.initials: J
authors.lastname: Echeverria
authors.forename: David Navarro
authors.initials: DN
authors.lastname: Ortega
authors.forename: José Martínez
authors.initials: JM
authors.lastname: Alarcón
authors.forename: Dionisia
authors.initials: D
authors.lastname: Fontanals
authors.forename: Bárbara Gomila
authors.initials: BG
authors.lastname: Sard
authors.forename: Buenaventura Buendía
authors.initials: BB
authors.lastname: Moreno
authors.forename: Luis
authors.initials: L
authors.lastname: Torroba
authors.forename: Josefina
authors.initials: J
authors.lastname: Ayats
authors.forename: Miguel Ángel Bratos
authors.initials: MÁ
authors.lastname: Pérez
authors.forename: María Alvarez
authors.initials: MA
authors.lastname: Fernández
authors.forename: Ferrán Sánchez
authors.initials: FS
authors.lastname: Reus
authors.forename: Isabel Fernández
authors.initials: IF
authors.lastname: Natal
authors.forename: Gloria Royo
authors.initials: GR
authors.lastname: García
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ezpeleta
authors.forename: Estrella
authors.initials: E
authors.lastname: Martín-Mazuelos
authors.forename: Isabel
authors.initials: I
authors.lastname: Iglesias
authors.forename: Antonio
authors.initials: A
authors.lastname: Rezusta
authors.forename: Inmaculada Ramírez
authors.initials: IR
authors.lastname: de Ocariz
authors.forename: Amelia Gómez
authors.initials: AG
authors.lastname: Nieto
mesh_terms: D000293:Adolescent; D000368:Aged; D002175:Candida / Q000187:drug effects; D002648:Child; D025141:Drug Resistance, Fungal; D005260:Female; D015725:Fluconazole / Q000494:pharmacology* / Q000627:therapeutic use*; D016469:Fungemia / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015725:Fluconazole